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      Ultra-short term HRV features as surrogates of short term HRV: a case study on mental stress detection in real life

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          Abstract

          Background

          This paper suggests a method to assess the extent to which ultra-short Heart Rate Variability (HRV) features (less than 5 min) can be considered as valid surrogates of short HRV features (nominally 5 min). Short term HRV analysis has been widely investigated for mental stress assessment, whereas the validity of ultra-short HRV features remains unclear. Therefore, this study proposes a method to explore the extent to which HRV excerpts can be shortened without losing their ability to automatically detect mental stress.

          Methods

          ECGs were acquired from 42 healthy subjects during a university examination and resting condition. 23 features were extracted from HRV excerpts of different lengths (i.e., 30 s, 1 min, 2 min, 3 min, and 5 min). Significant differences between rest and stress phases were investigated using non-parametric statistical tests at different time-scales. Features extracted from each ultra-short length were compared with the standard short HRV features, assumed as the benchmark, via Spearman’s rank correlation analysis and Bland-Altman plots during rest and stress phases. Using data-driven machine learning approaches, a model aiming to detect mental stress was trained, validated and tested using short HRV features, and assessed on the ultra-short HRV features.

          Results

          Six out of 23 ultra-short HRV features (MeanNN, StdNN, MeanHR, StdHR, HF, and SD2) displayed consistency across all of the excerpt lengths (i.e., from 5 to 1 min) and 3 out of those 6 ultra-short HRV features (MeanNN, StdHR, and HF) achieved good performance (accuracy above 88%) when employed in a well-dimensioned automatic classifier.

          Conclusion

          This study concluded that 6 ultra-short HRV features are valid surrogates of short HRV features for mental stress investigation.

          Electronic supplementary material

          The online version of this article (10.1186/s12911-019-0742-y) contains supplementary material, which is available to authorized users.

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          Most cited references48

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          Surrogate end points in clinical trials: are we being misled?

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            The appropriate use of approximate entropy and sample entropy with short data sets.

            Approximate entropy (ApEn) and sample entropy (SampEn) are mathematical algorithms created to measure the repeatability or predictability within a time series. Both algorithms are extremely sensitive to their input parameters: m (length of the data segment being compared), r (similarity criterion), and N (length of data). There is no established consensus on parameter selection in short data sets, especially for biological data. Therefore, the purpose of this research was to examine the robustness of these two entropy algorithms by exploring the effect of changing parameter values on short data sets. Data with known theoretical entropy qualities as well as experimental data from both healthy young and older adults was utilized. Our results demonstrate that both ApEn and SampEn are extremely sensitive to parameter choices, especially for very short data sets, N ≤ 200. We suggest using N larger than 200, an m of 2 and examine several r values before selecting your parameters. Extreme caution should be used when choosing parameters for experimental studies with both algorithms. Based on our current findings, it appears that SampEn is more reliable for short data sets. SampEn was less sensitive to changes in data length and demonstrated fewer problems with relative consistency.
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              Acute mental stress assessment via short term HRV analysis in healthy adults: A systematic review with meta-analysis

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                Author and article information

                Contributors
                r.castaldo@warwick.ac.uk
                L.Montesinos-Silva@warwick.ac.uk
                paolo.melillo@unicampania.it
                c.james@warwick.ac.uk
                l.pecchia@warwick.ac.uk
                Journal
                BMC Med Inform Decis Mak
                BMC Med Inform Decis Mak
                BMC Medical Informatics and Decision Making
                BioMed Central (London )
                1472-6947
                17 January 2019
                17 January 2019
                2019
                : 19
                : 12
                Affiliations
                [1 ]ISNI 0000 0000 8809 1613, GRID grid.7372.1, School of Engineering, , University of Warwick, ; CV47AL, Coventry, UK
                [2 ]ISNI 0000 0000 8809 1613, GRID grid.7372.1, Institute of Advanced Studies, , University of Warwick, ; CV47AL, Coventry, UK
                [3 ]ISNI 0000 0001 2200 8888, GRID grid.9841.4, Multidisciplinary Department of Medical, Surgical and Dental Sciences, , University of Campania Luigi Vanvitelli, ; Naples, Italy
                Author information
                http://orcid.org/0000-0002-7900-5415
                Article
                742
                10.1186/s12911-019-0742-y
                6335694
                30654799
                915241b3-1df5-473a-a6c8-5378bad32061
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 21 December 2017
                : 10 January 2019
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Bioinformatics & Computational biology
                heart rate variability (hrv),ultra-short term hrv analysis,mental stress detection,data-driven machine learning

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